Pharmacy Services Coordinator

3 days ago


Rancho Cordova, California, United States Talent Software Services Full time
Job Description:

The Pharmacy Services team plays a vital role in providing exceptional customer service to external customers and internal team members. As a key member of this team, you will be responsible for resolving pharmacy benefit coverage issues, communicating drug formulary guidelines, and researching administrative review and consumer affairs issues.

Key Responsibilities:
  • Coordinate and implement procedures for the drug prior authorization program for the outpatient Pharmacy Benefit.
  • Communicate with physicians, medical management, and other team members to resolve prior authorization requests efficiently.
  • Provide formulary alternatives and communicate prior authorization criteria to ensure accurate and efficient resolution of pharmacy benefit coverage issues.
  • Interface with physicians, pharmacists, patients, and other team members in a professional and courteous manner during the prior authorization process.
  • Assist pharmacists with drug utilization review programs and other assigned projects.
  • Communicate prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to various stakeholders.
  • Assist in research and resolution of physician inquiries and grievances.
Requirements:
  • Currently in training or recently completed training with a focus on pharmacy services.
  • 2-4 years' experience in a related field.


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